JOB APPLICATION

Direct Application Through Agency Referred

Indicate Name:

PHOTO
Position Applied : Facility engineer

Notice Period : Immediate

SECTION A – PERSONAL PARTICULARS

Name per IC/Passport Bijumon Bismi (please underline surname)

Country of Birth India Date of Birth (ddmmyy)

Citizenship Singapore Citizen Perm Resident (effective ddmmyy: 27/06/2022) Others:

Gender Male Female

Marital Status Single Married

Address Blk 354, woodlands avenue 1, #10-769, 730354 Postal Code 730354

Home Phone Number

Email Address [email protected] Mobile Phone Number +65 88093200

SECTION B - EDUCATION AND OTHER PROFESSIONAL QUALIFICATIONS

Highest Qualification From To
Name of Institution Major in
Attained (ddmmyy) (ddmmyy)

Temasek Polytechnic, Tampines Diploma 04/2018 04/2021 Mechatronics

1 HR Policy_Forms
 JOB APPLICATION

SECTION C - LANGUAGE PROFICIENCY

Language Written Spoken
(Fluent/Average) (Fluent/Average)

English Fluent Fluent

Malayalam Fluent Fluent

Tamil Average Average

SECTION D - NATIONAL SERVICE (Please attach discharge certificate, if any)
1. Have you completed National Service? Not Applicable Yes No Full-time Part-time Exempted

2. If yes, state: Enlistment Date

ORD Date
Rank in N.S.
Vocation in N.S.
Next Reservist date
3. If No, when are you due for N.S.?

4. If you are exempted from N.S., state reasons.

SECTION E - EMPLOYMENT HISTORY (Please start with your most recent employment)
Date Basic Salary
Reasons For Leaving
From To Name of Employer Job Title
Starting Last Drawn
(ddmmyy) (ddmmyy)

05/05/2021 10/10/2022 Micron Semiconductors Asia Pt Ltd Associate engineer $2200 $2563 Retrenchment

2 HR Policy_Forms
 JOB APPLICATION

SECTION F - REFERENCES (Please provide 3 references. At least one should be from your current/last employment)

Name Designation and Company Email Address Contact Number Relation

Jia Rui Lim Engineer, micron semiconductor +65 8323 2482 Supervisor

Indra Technical specialist, micron 9450 2480 Shift lead

SECTION G - OTHERS
Yes / No
1. Have you ever been dismissed or your employment is terminated by an employer? If Yes, please state details:

Yes / No
2. Have you ever been convicted in a court of law in any country or detained under the provisions of any
If Yes, please state details:
written law?
Yes / No
3. Have you ever been investigated by the Commercial Affairs Department (CAD), Criminal Investigation
If Yes, please state details:
Department (CID), Corrupt Practice Investigation Bureau (CPIB) or other government investigation department?
Yes / No
4. Have you ever been declared a bankrupt? If Yes, please state details:

Yes / No
5. Do you have any breach of Security Information with your previous employers? If Yes, please state details:

6. Are there any restrictions regarding your employment? Example.

(a) Did you sign any Non Competition clause with your current/previous employer? Yes / No
(b) Do you have any undischarged bonds with your current/previous employer? Yes / No
(c) Others (Please specify)

Yes / No
7. Are you holding a directorship or other appointment in any company? If Yes, please state details:
Yes / No
8. Is there anything concerning your medical history or state of health that is relevant to this job application? If Yes, please state details:

Yes / No
9. Do you have a driving license? Class _ (Please state the class of the driving license) If Yes, please state details:

3 HR Policy_Forms
 JOB APPLICATION

SECTION H - APPLICANT’S DECLARATION

Note to Applicant:

Your application will be disqualified if it is found that you have either willfully suppressed material facts or knowingly given false
particulars. If, after the engagement, it is found that you have knowingly made a false declaration on the form, the Company
reserves the right to terminate your employment/services without notice.

 I understand that submission of false information, misrepresentation in this application or omission of facts will be sufficient
cause for cancellation of consideration for employment or dismissal from the Company's service if I have been employed.

 I understand that completing this application is not a promise of employment from the Company or its subsidiaries.

 I authorize the Company to confirm any of the statements above and also give the Company the right to investigate my
background at any time.

 I hereby declare that all the information provided in the application and on the attached resume is true, complete and
accurate.

 I hereby agree to the collection, storage, processing, access, review, disclosure and/or use of my personal data for the
purposes listed above and/or any other evaluative purposes and/or the purpose of managing and/or terminating my
employment with the Company or its subsidiaries.

 I hereby waive any claims against the Company and its current/former officers, directors, and employees based upon its use
of the information it receives during the course of this employment reference in determining my qualifications for a
position. I understand that my failure to consent to this reference request will make me ineligible for employment (or
continued employment) at the Company.

10/4/2023

Signature of Applicant Date

Bijumon Bismi

Name of Applicant

4 HR Policy_Forms
 INTERVIEW EVALUATION FORM
Evaluator’s Name: Interviewee’s Name: Date of Interview:

SCORE:
This is a guide so that we are able to identify areas of agreement and disagreement for discussion. Add the score numbers to the
task questions in the space provided.
1 2 3 4 5
No skills or ability to Some experience and Skills and experience Almost fully meeting Fully meet expectation and
perform this skill / understanding and partially meet expectation for this very likely to excel.
task category. perhaps able to expectations but job and likely to excel
perform in a guided some areas may still in some aspects of
role, i.e.: close require additional the skills category.
supervision by others. support.
Note: If you score any task below 2 or less, raise as a point for post interview discussion. Some low scoring task may compromise suitability of
recruitment even though total score may be high.

SCORING
Note: These are proposed areas for evaluation. Please feel free to amend if necessary, especially if emphasis is needed in different aspects that
are critical to the position.

ESSENTIAL CAPABILITIES SCORE (circle as needed)

Experience
1 2 3 4 5
(relevant to the position)
Education / Training
1 2 3 4 5
(relevant to the position)
Communication
(language proficiency, ability to express himself, conversation 1 2 3 4 5
engagement)
Motivation & commitment
1 2 3 4 5
(interest, willingness to learn, career goal)
Presentation
1 2 3 4 5
(promptness, neatness of resume / appearance)
TOTAL SCORE

ADDITIONAL COMMENTS & RECOMMENDATIONS

REMARK

Proposed Worksite

Items needs upon on boarding (tick as needed):

Laptop / Desktop Email
Safety Course Others

Note: This evaluation sheet does not serve as the final decision of hiring or rejection, but serves as a reference / discussion tool to
the interviewer and HR.